Claims Technician Resume Samples

A Claims Technician provides back up and supports in all areas of insurance work. Most of the job description revolves around clerical and administrative work, routine correspondence, updating records, and dealing with client’s inquiries. A professional Claims Technician Resume describes the following duties and responsibilities – studying the proposal form, getting further information if necessary; using standard rates to quote the premium; passing inquiries about complicated risks; checking the claim details; ensuring the policy covers the claim, asking for evidence such as receipts, photographs, and jewelry valuations; asking for information; and arranging for immediate payment.

Those seeking this job role should have strong knowledge of the insurance work and the following handy skills – strong customer service skills; numeracy skills; the ability to work calmly under pressure; attention to details; the ability to use initiative and work as a team member; and assertiveness. Above all, communication skills are also a must. Employers’ expectation varies from company to company, however to the least a high school diploma or GED is mandatory.

 

Claims Technician Resume example

Claims Technician Resume

Objective : An accomplished and educated Claims Technician professional with two years' experience. Familiar with the daily aspects of business operations and experience; extensive insurance procedures and documentation knowledge.

Skills : File Maintenance, Order Processing, Stocking, Customer Service.

Description :

    1. Responsible for schedule loss of use and ongoing treatment cases.
    2. Responsible for maintenance files to ensure timely payments.
    3. Managed caseload of over five hundred inclusive of maintenance files, scheduled loss of use cases, and ongoing treatment cases.
    4. Entered data regarding automobile and general liability claims.
    5. Processed checks relevant to claim to cover towing, glass, and medical expenses.
    6. Worked in a call center and processed tire warranty claims for clients.
    7. Managed the claim process from start to finish and made the final decision.
    8. Sent the appropriate documents to the requesting parties for the workman's compensation claims.
Years of Experience
Experience
0-2 Years
Experience Level
Level
Entry Level
Education
Education
Associates In General Studies


Claims Technician Resume

Objective : To obtain a Claims Technician position that will utilize my compensation experience, leadership skills, and training abilities for the development of the organization.

Skills : Commercial Property, Customer Service, Data entry.

Description :

    1. Gathered, timely and accurate information to ensure the data integrity of all severity claims processed and handled.
    2. Reached the required parties, such as attorneys, brokers, customers, experts, etc.
    3. Ensured data completeness and accuracy, as necessary.
    4. Independently monitored and acted on incoming information in a timely fashion.
    5. Verified policy coverage - researched policy information and loss/claim details, to confirm coverage.
    6. Requested and obtained supporting coverage information, including policy, endorsements, and additional account-specific instructions.
    7. Obtained and ensured policy information is up to date in the processing systems.
    8. Worked with relevant parties to locate and update policy coverage details.
Years of Experience
Experience
0-2 Years
Experience Level
Level
Entry Level
Education
Education
GED


Claims Technician Resume

Objective : To secure a Claims Technician position with a leading organization that will lead to a long term career relationship with the company.

Skills : Customer Service, Loss Reports, Management.

Description :

    1. Processed claims in a timely manner while maintaining accuracy.
    2. Advanced provider phone calls to obtain info regarding claims on the processor level.
    3. Investigated claims that were escalated to the examiner level.
    4. Worked with the Host plan to complete escalated claims on the Bluecard side of the business.
    5. Investigated claims submitted by Medicare and Medicaid entities.
    6. Investigated both Bluecard and Regular business records to determine the eligibility of benefits.
    7. Trained examiner level claim responsibilities in a classroom setting.
Years of Experience
Experience
2-5 Years
Experience Level
Level
Junior
Education
Education
BA In Technician

Claims Technician Resume

Headline : To obtain a Claims Technician position where I have the ability to utilize my public relations skills, clerical skills, and organization skills with the opportunity for advancement and stability.

Skills : Medical Records, Administrative, Customer Service, Microsoft Office.

Description :

    1. Managed the Electronic Data Interchange (EDI) of health care claim files.
    2. Liaised with customers to configure new FTP and SFTP file transfer connections.
    3. Ensured claim files comply with ASC X12N 837p and 837i standards.
    4. Troubleshoot and coordinated the correction of PGP encryption errors.
    5. Coordinated EDI traffic with external clearinghouses and business partner Multiplan.
    6. Assisted in the translation of HCFA1500 and UB92 data to and from 837p and 837i formats.
    7. Maintained OneNet's Companion Guide, act as a technical liaison to external customers.
Years of Experience
Experience
5-7 Years
Experience Level
Level
Executive
Education
Education
GED

Claims Technician Resume

Objective : Highly qualified Claims Technician with experience in the industry. Enjoy creative problem solving and getting exposure on multiple projects, and I would excel in the collaborative environment on which company prides itself.

Skills : Microsoft Office, Data entry, General liablity.

Description :

    1. Experienced in working VA disability claims for Veterans, gathered all the correct information for the claims to be rated for compensation and/or pension.
    2. Experienced in scheduling medical exams for Veterans to ensure the veteran is getting the correct medical help.
    3. Verified guidance and examination of military documents and VA forms prior to being sent to the RO for a rating.
    4. Planned and organized the processing of claims and claim documents when there is a problem or question with the claim.
    5. Provided assistance to the claims technicians for accuracy when it comes to claims with errors.
    6. Contacted other Regional Offices for the correct information for claims sent to our office in error.
    7. Provided development to the examiners: action plans were created for struggling examiners.
Years of Experience
Experience
0-2 Years
Experience Level
Level
Entry Level
Education
Education
B.S In Technician

Claims Technician Resume

Summary : Seeking a Claims Technician position utilizing my extensive knowledge and successful experience; and to obtain a position that fosters communication, excellent customer service, teamwork and growth, in which motivation and the capacity to excel will prove valuable.

Skills : Customer Service, Clerical, Medical Records.

Description :

    1. Handled all medical-only Virginia Workers' Compensation claims.
    2. Reviewed claims to determine compensability. Authorized related medical treatment.
    3. Maintained diary for PTD/PPD payout cases and initiated affidavit letters to validate survivorship and receipt of payments.
    4. Researched and verified insurance coverage.
    5. Handled various incoming customer service calls as active support of the workers' Compensation Department.
    6. Supported all technical needs (duties include but are not limited to drafting letters, updating coverage information, Xeroxing and organizing files, etc.) Coded and setup of new claims.
    7. Liaised for agents and service claims representatives. Handled all medical-only claims.
Years of Experience
Experience
10+ Years
Experience Level
Level
Senior
Education
Education
B.S In Finance

Claims Technician Resume

Objective : To secure a challenging Claims Technician position where my diversified professional experience, excellent interpersonal, and solving skills can utilize to execute and meet your company's goals.

Skills : Phone calls, Workers Compensation, Data entry

Description :

    1. Reviewed insurance policies to determine coverage.
    2. Obtained information from medical reports, photographs.
    3. Provided instructions for claims proceedings.
    4. Attached information to claim files.
    5. Transmitted claims for payment or further investigation. Investigated claims.
    6. Submitted recommendations to the case supervisor.
    7. Ensured timely and accurate claims payments.
Years of Experience
Experience
0-2 Years
Experience Level
Level
Entry Level
Education
Education
GED

Claims Technician Resume

Summary : Professional and reliable administrator seeking a dynamic administrative Claims Technician position with a thriving business who is seeking a hard worker with excellent interpersonal communication and office skills.

Skills : Investigation, Account management, Claims management.

Description :

    1. Handled loss recovery claims with salvage facilities.
    2. Coordinated with salvage facilities to timely disposal of salvage to obtain maximum recovery.
    3. Reconciled and maintained all claims related vendor and payment information.
    4. Maintained batch control records. Provided conflict resolution.
    5. Proffered recommendations on the appropriate handling of complex total loss cases to management to ensure contractual and state regulation compliance and final disposal of non-sell vehicles.
    6. Acted as liaison with salvage facilities.
    7. Provided prompt professional and appropriate customer service to customers.
Years of Experience
Experience
10+ Years
Experience Level
Level
Senior
Education
Education
High School Diploma

Claims Technician Resume

Objective : To become an integral member of a well established and respected company, that would provide stability, personal growth and broaden my skills and abilities for the benefit of the company.

Skills : Microsoft Office, Medicaid, Management.

Description :

    1. Provided high quality of customer service for internal and external customers within specified time service standards.
    2. Maintained insurance knowledge of the related units.
    3. Received and recorded loss reports by entering all first notices for personal and commercial property, auto, general liability, and workman's compensation claims.
    4. Provided instructions to policyholders or claimants on how to proceed with claims.
    5. Supported calls resulting from customer self-service.
    6. Occasionally faxed and filed and all other aspects of a running office.
    7. Opened, sorted, identified, matched, and distributed claim files and mail.
Years of Experience
Experience
0-2 Years
Experience Level
Level
Entry Level
Education
Education
GED

Claims Technician Resume

Objective : Highly motivated and dedicated Claims Technician professional with over 2 years of experience. Expertise includes customer service, scheduling, and problem-solving abilities. A detail-orientated and adaptable team player with proven time management skills.

Skills : Microsoft Office, Claims Department, Customer Service.

Description :

    1. Entered claims into the computer system, directing telephone calls and taking accident reports.
    2. Verified policy coverage for claims and set up claims into the computer system.
    3. Answered telephone and directed incoming calls for the Claims Department.
    4. Assigned Risk Policy Processing Technician, Provided administrative services in the processing of high-risk insurance policies.
    5. Manually typed policies, rates, and endorsements into the computer system.
    6. Mailed and distributed polices. Issued certificates of insurance.
    7. Filed all state-required policy information with each state.
Years of Experience
Experience
0-2 Years
Experience Level
Level
Entry Level
Education
Education
Diploma In Technician